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Hemorrhagic Disorders (Early Pregnancy Bleeding
Serious complication…
Hemorrhagic Disorders
Early Pregnancy Bleeding
- Serious complication immediate attention
Spontaneous Abortion
- End of pregnancy before 20th weeks GA, natural causes
- Induced - artificial by meds or mechanical means for therapeutic/personal reason
Threatened - bleeding w/o knowing
Imminent - going to happen
Incomplete - pass product of conceptions
Complete - everything has passes
Missed - there is a sac, but no FHR; body should have aborted, but did not
Recurrent - habitual
Septic
Etiology
- ~50% result from chromosomal abnormalities
Maternal factors:
- Infections - herpes, GBS, syphilis
- Progesterone deficiency
- Autoimmune - antiphospholid antibody syndrome
- Drugs and environmental chemicals - smoking, alcohol, mercury
-
Ectopic Pregnancy
- any preg that occurs when embryo implants in tissue other than lining of uterus
Would show lower abdominal pain
- Tubal - most common
- Ovarian
- Cervical
- Abdominal
Risk Factors- want to get before it ruptures
- Tubal damage
- Previous pelvic or tubal surgery
- Endometriosis
- IUD
- Smoking
- Advanced maternal age
- Primary infertility
Classic Symptoms
- Abdominal pain
- Amenorrhea
- Vaginal bleeding (maybe)
Fallopian Tube Distention pain is early
- vague pain or cramping
- Right or left pelvic areaa
Rupture Symptoms
- Abdominal pain
- Palpable pelvic mass
- Dizziness
- eventually -> Hypovolemic shock
Diagnosis by:
- Ultrasound
- Progesterone evaluation
- hCG levels
Normal - sac seen @ 5-6 weeks
Ectopic - positive preg test, but inability to visualize sac
-
Nursing Care
- Assess bleeding
- Vitals
- Emotional status and coping
- Education
- Postop care, RhoGam
Nursing Diagnosis
- Fear
- Acute pain
- Grief
- Knowledge deficit
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